Nicolas Magné

Institut de cancérologie Lucien-Neuwirth, La Fouillouse, Rhône-Alpes, France

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Publications (171)569.17 Total impact

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    ABSTRACT: Background: Despite radiotherapy (RT) technical improvements, high salivary dysfunction rates are still reported in patients with head and neck squamous cell carcinoma (HNSCC). The purpose of the present study was to report salivary glands dosimetry with volumetric-modulated arc therapy (VMAT) and intensity-modulated RT (IMRT). Methods: Dosimetry of consecutive patients receiving IMRT or VMAT for proven HNSCC between 2007 and 2013 were retrospectively reviewed. Results: Data of 609 patients were studied. Mean dose, mean maximum dose, and mean percentage of salivary gland volume receiving at least 26 Gy (V26) of the contralateral parotid were 24.50 Gy (range, 0-70.4 Gy), 39.08 Gy (range, 0.38-76.45 Gy), and 40.92% (range, 0% to 100%), respectively. Mean and maximum dose on contralateral submandibular gland were 48.18 Gy (range, 0.19-70.73 Gy), and 61.25 Gy (range, 0-75.8 Gy), respectively. Conclusion: Target volume coverage still has to be prioritized over organs at risk (OAR) sparing with new RT techniques. Submandibular glands are not sufficiently taken into account in guidelines. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.
    No preview · Article · Feb 2016 · Head & Neck
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    ABSTRACT: Les congrès de 2015 en oncologie ont été répartis à travers tous les continents. Une sélection par le comité éditorial du Bulletin du cancer a été réalisée parmi les meilleurs résumés, présentations et articles publiés dans les différents domaines de spécificité de l’oncologie. Ces focus permettent une vision synthétique des avancées majeures de l’année.
    No preview · Article · Jan 2016
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    ABSTRACT: Background: We studied the efficacy and safety of cabazitaxel in unselected real-life patients. Patients and methods: We retrospectively investigated all patients with metastatic prostate cancer (mPC) treated with cabazitaxel 25 mg/m2 i.v. every 3 weeks combined with oral prednisolone (10 mg once daily) after first-line docetaxel chemotherapy. Study issues were to report patient characteristics and cabazitaxel data in terms of tolerance and efficacy. Overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method. All data were compared with TROPIC results. Results: From 2011 to 2014, 41 patients received cabazitaxel; 15 patients (37%) had a performance status (PS) ≥2 versus 7% (p < 0.0001) in TROPIC, and 38 patients (93%) presented a Gleason score ≥7 at baseline (vs. 60%; p < 0.0001). All patients had metastatic disease at baseline. Previous therapies were radiotherapy in 17 patients (41 vs. 61%; p = 0.01) and surgery in 24 patients (59 vs. 52%; p = 0.4). The median number of cabazitaxel cycles was 5 (1-10) versus 6 (3-10) in TROPIC. Five patients completed 10 cycles of cabazitaxel (12%) versus 28% in TROPIC (p = 0.03). Toxicities were anemia (12 patients, 29%), diarrhea (9 patients, 22%), nausea (7 patients, 17%), pain (6 patients, 15%), sepsis (4 patients, 10%), neutropenia (3 patients, 7%) and urinary tract infection (1 patient, 2%). The tumor response rate was 19.5 versus 14.4% in TROPIC (nonsignificant). PFS was 4.5 months (95% CI 3.3-6.4) in our analysis and 2.8 months (95% CI 2.4-3.0) in TROPIC. OS was 12.1 months (95% CI 9.2 to not reached) and 15.1 months (95% CI 14.1-16.3), respectively. Conclusion: In our unselected mPC patients with poorer baseline clinical conditions and aggressive disease, cabazitaxel seems efficient and not more toxic than in the TROPIC study.
    No preview · Article · Jan 2016 · Chemotherapy
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    ABSTRACT: Background: Trabectedin plus pegylated liposomal doxorubicin (PLD) proved efficacious as second-line treatment for patients with recurrent ovarian cancer (ROC). Methods: We report a single-center retrospective analysis of the efficacy and tolerance of trabectedin 1.1 mg/m2 every 3 weeks in a cohort of real-life ROC patients. Results: From February 2012 to January 2014, 17 patients were treated with trabectedin alone or combined with PLD. Median age was 61 years (range: 48-78). Performance status was 0-1 in 16 patients (94%). Disease response rate was 53% and disease control rate was 76%. At the end of the follow-up, 8 patients (47%) were alive. Median overall survival was 17.6 months (95% CI 13.6 to not reached). Median progression-free survival was 6.7 months (95% CI 5.4-10.0). The most frequent grade 3-4 toxicities were neutropenia (n = 4, 24%) and nausea/vomiting (n = 4, 24%). Conclusion: Trabectedin combined with PLD seems efficient in and well tolerated by real-life ROC patients.
    No preview · Article · Jan 2016 · Chemotherapy
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    ABSTRACT: Radiation therapy is a cornerstone of head and neck cancer management. Technological improvements in recent years in radiation therapy, with intensity-modulated techniques, reinforce even more its role. However, both local and locoregional relapses are still observed. Understanding biological mechanisms of treatment resistance is a topic of major interest. From the cancer cell itself, its ability to repair and proliferate, its microenvironment and oxygenation conditions, migratory and invasive capacity, to biological parameters related to the patient, there are many mechanisms involving radiosensitivity and/or radioresistance of head and neck cancer. The present study explores the main biological mechanisms involved in radiation resistance of head and neck cancer, and describes promising therapeutic approaches.
    Full-text · Article · Dec 2015 · Bulletin du cancer
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    ABSTRACT: Recent evidences suggest that many types of cancers contain a cell population presenting stem cell properties. While the great majority of tumor cells are destined to differentiate, and eventually stop dividing, only a minority population of cells, termed cancer stem cells (CSCs), possesses extensive self-renewal capability and can recapitulate tumor pathophysiology in an immune-compromised animal model. Tumor initiating cells have been identified and isolated in many tumor types including brain, colon and prostate. They are virtually resistant to radiation and may contribute to treatment resistance and recurrence. Therefore, therapies specifically targeting CSCs will likely be needed for complete tumor eradication. The present study reviews published reports identifying the mechanisms of radioresistance of CSCs and potential targets based on the pathways of self-renewal. Further elucidation of pathways that regulate CSCs may provide insights into the development of novel innovative therapies.
    Full-text · Article · Dec 2015 · Bulletin du cancer
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    ABSTRACT: Objectives: The aim of this study was to report the first cases of salvage radiotherapy using the Intensity-Modulated Radiotherapy (IMRT) with Simultaneous Integrated Boost (SIB) targeted on choline PET uptake in a local recurrent prostate cancer, after a radical prostatectomy. Methods: 4 patients received salvage irradiation for biochemical relapse that occurred after the initial radical prostatectomy. The relapse occurred from 10 months to 6 years with PSA levels ranging from 2.35 to 4.86 ng/ml. For each patient, a (18)F-Choline PET-CT showed a focal choline uptake in prostatic fossa, with standardized uptake value calculated on the basis of predicted lean body mass (SUL) max of 3.3-6.8.No involved lymph node or distant metastases were diagnosed. IMRT doses were of 62.7 Gy (1.9 Gy/fraction, 33 fractions), with a SIB of 69.3 Gy (2,1 Gy/fraction, 33 fractions) to a PET-guided target volume. Results: Acute toxicities were limited. We observed no gastrointestinal toxicity ≥grade 2 and only one grade 2 genitourinary toxicity. At one month follow-up evaluation, no complication and a decrease in PSA level (6.8% to 43.8% of the pre-therapeutic leve) were reported. After 4 months, a decrease in PSA level was obtained for all the patients, ranging from 30 to 70%. At a median follow up of 15 months, PSA level was controlled for all the patients, but one of them experienced a distant lymph node recurrence. Conclusions: Salvage irradiation to the prostate bed with SIB guided by PET-CT is feasible, with biological efficacy and no major acute toxicity. Advance in knowledge: IMRT with PET oriented SIB for salvage treatment of prostate cancer is possible, without major acute toxicity.
    No preview · Article · Dec 2015 · The British journal of radiology

  • No preview · Article · Dec 2015 · Molecular Cancer Therapeutics
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    ABSTRACT: Background: The elderly population in Western countries is growing and constitutes a public health issue. Concomitantly, age-related diseases such as cancer increase. There are few data on the efficacy, tolerability and toxicity of specific anticancer therapy in the very elderly patients; therefore, their management is not standardized. Methods: In this bi-institutional study, we reviewed medical records of patients who received or continued specific anticancer therapy beyond the age of 90 years. Geriatric assessment was not reported for our patients. Twelve patients were enrolled. Their general health condition was good, and half of them were living in elderly institutions. Ten patients had a solid tumor and 2 were treated for hematological malignancies. Most were diagnosed with a locally advanced or metastatic disease, and the goal of treatment was curative for only 1 patient. Six patients received chemotherapy as first-line treatment, 4 patients received targeted therapy and 2 received concomitant chemoradiation. Four patients received a second-line treatment. Results: Despite a significant reduction in treatment posology in half of the patients, 8 acute grade 3/4 toxicities were reported and 2 patients died of treatment-related septic shock. Median duration of first-line treatment was 3.2 months, and progression-free survival ranged from 18 to 311 days. Overall survival ranged from 18 days to 11 years. Conclusion: Aging is a heterogeneous process, and management of elderly patients is a multidisciplinary approach. Geriatric assessment helps to identify older patients with a higher risk of morbidity/mortality and allows to assess the risks and benefits of specific anticancer therapy. The choice of treatment should be based primarily on the expected symptomatic benefit, and treatment should not compromise the quality of life.
    No preview · Article · Nov 2015 · Chemotherapy
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    ABSTRACT: Context: The European Deprivation Index (EDI), is a new ecological estimate for Socio-Economic Status (SES). This study postulates that Time-To-Treatment could be used as a cancer quality-of -care surrogate in order to identify the association between cancer patient's SES and quality of care in a French comprehensive cancer center. Methods: retrospective mono-centered cohort study. All consecutive incoming adult patients diagnosed for breast cancer(BC), prostate cancer(PC), colorectal cancer (CRC), lung cancer(LC) or sarcoma(S) were included between January 2013 and December 2013. The association of EDI and Time-To-Diagnosis(TTD), as well as Time-To-Treatment(TTT) was analyzed using a cox regression, and a strata analysis per tumor site was performed. Results: 969 patients were included. Primitive tumor site was 505 BC(52%), 169 PC(17%), 145 LC(15%), 116 CRC(12%), and 34 S(4%). Median TTD was 1.41 months (Q1-Q3 0.5 to 3.5 months). Median TTT was 0.9 months (0.4 - 1.4). In a multivariate analysis, we identified the tumor site as a predictive factor to influence TTD, shorter for BC (0.75months, [0.30- 1.9]) than PC (4.69 months [1.6-29.7]), HR 0.27 95%CI= [0.22-0.34], p < 0.001. TTT was also shorter for BC (0.75months [0.4-1.1]) than PC (2.02 [0.9-3.2]), HR 0.32 95%CI= [0.27-0.39], p < 0.001. EDI quintiles were not found associated with either TTT or TTD. Conclusions: Deprivation estimated by the EDI does not appear to be related to an extension of the Time-to-Diagnosis or Time-to-Treatment in our real-life population. Further research should be done to identify other frailty-sensitive factors that could be responsible for delays in care.
    Preview · Article · Nov 2015 · Oncotarget
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    ABSTRACT: Le service de santé des armées effectue la surveillance médicale des 340 000 militaires français. L’objectif de ce travail était de décrire les pratiques de dépistage des cancers solides par les médecins militaires généralistes, et de les confronter aux recommandations de l’Institut national du cancer.
    No preview · Article · Nov 2015
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    ABSTRACT: Conclusion: The present study demonstrates the feasibility of VMAT in association with platin or cetuximab in HNSCC and reports VMAT-related acute and late toxicities for the first time. Objectives: New radiotherapy techniques, such as Volumetric Modulated Arc Therapy (VMAT) were developed to lower RT-related toxicity. The aim of the present study was to investigate acute and late toxicities of head and neck squamous cell carcinoma (HNSCC) patients treated using VMAT. Methods: This study investigated retrospectively all patients with HNSCC who received VMAT in curative intent. Results: From 2010-2013, 150 patients were treated. Seventy-five patients (50%) received concurrent chemotherapy with VMAT, 51 patients (34%) received VMAT alone and 24 patients (16%) received concurrent cetuximab with VMAT. Mean delivered dose to planning target volume tumor (PTV T), high risk nodes (PTV HNR), low risk nodes (PTV LNR) and prophylactic nodes (PTV PN) were: 65.2 Gy, 62.9 Gy, 55.4 Gy, and 51.5 Gy, respectively. PTV mean coverages were higher than 96.5%. Most common grade 3/4 acute infield toxicities were mucosis (n = 28, 19%), dysphagia (n = 24, 16%), and dermatitis (n = 24, 16%). With a median follow-up of 16.0 months, most common late toxicities were dysphagia (n = 30, 20%), xerostomia (n = 28, 19%), larynx stiff (n = 17, 11%), and skin fibrosis (n = 14, 9%).
    No preview · Article · Oct 2015 · Acta oto-laryngologica
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    ABSTRACT: Cervical cancer is one of the most prevalent malignancy and of higher mortality in the world, and is considered a marker of underdevelopment. Conventional radiotherapy is one of the treatments used for this type of cancer. 30 to 40% of patients with similar prognosis factors not respond equally to a comparable standard treatment. The poor response to radiotherapy leads to the development of innovative and effective therapies for cervical cancer locally advanced, metastatic and refractory. A comparative analysis of cervical cancer in the context of other cancers may reveal that it is relatively smaller number of targeted molecular agents that have been tested. Accordingly, a number of biological agents are currently in clinical development for the purpose of, inhibiting angiogenesis, molecularly address EGFR and IGF-1R, modulation of cell cycle, of histone deacetylases, COX-2, mTOR and tumor microenvironment (hypoxia and glycolysis). Within work that we have been developing in cervical cancer with relationship to treatment, we reported that gene expression of IGF1R is a strong predictive marker for lack of response to radiotherapy, patients with expression of IGF1R have 28.6 times higher risk of failure treatment; the expression of IGF-IRβ detected by immunohistochemistry is a prognostic marker that affects overall survival and disease-free survival; the detection and study before treatment of the expression of CAIX, GLUT 1 and HKII, considered as biological factors pre-existing, contributes to infer the metabolic and hypoxic state, as also at the rational use of new modalities in radiotherapy and gene therapy in the regulation of hypoxia.
    No preview · Article · Oct 2015 · International Journal of Gynecological Cancer
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    ABSTRACT: Objective: The objective was to identify acute skin toxicity risk factors linked to anthropometric characteristics of breast cancer patients treated with radiation therapy. Methods: Consecutive patients with breast cancer were enrolled after breast-conserving surgery, and before radiotherapy course. Acute skin toxicity was assessed weekly during the 7 weeks of radiotherapy with the International Classification from National Cancer Institute. Grade 2 defined acute skin toxicity. Patient characteristics and anthropometric measurements were collected. Results: 54 patients were enrolled in 2013. Eight patients (14.8%) had ≥ grade 2 toxicity. The average weight and chest size were 65.5 kg and 93.6 cm, respectively. Bra cup size is significantly associated with a risk of grade 2 dermatitis (OR 3.46, 95% CI (1.29 to 11.92) with p < 0.05). Anthropometric breast fat mass measurements such as thickness of left (OR 2.72, 95% CI (1.08 to 8.26) p = 0.04) and right (OR 2.45, 95% CI (0.99 to 7.27) p = 0.05) axillary fat, are correlated with an increased risk. Distance between pectoral muscle and nipple is a reproducible measurement of breast size, and is associated with acute skin toxicity with significant tendency (OR=2.21; CI 95% (0.97-5.98), p=0.07). Conclusions: Breast size and its different anthropometric measurements (thickness of left and right axillary fat, nipple to pectoral muscle distance) are correlated with the risk of skin toxicity. Advances in knowledge: The present article analyzes several characteristics and anthropomorphic measurements of breast in order to assess breast size. A standardized and reproducible protocol to measure breast volume is described.
    No preview · Article · Sep 2015 · The British journal of radiology
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    ABSTRACT: Objective: The aim of our study was to evaluate emotional distress among women with breast cancer treated by radiotherapy, using a Visual Analogue Scale (an adaptation of the "Distress Thermometer" French version) associated with a Needs Scale with several items, in order to identify patients requiring psychological care. Method: Our sample is composed of 277 women treated for breast cancer with radiotherapy. Our psychological evaluation is made of a first enquiry using a visual analogue distress scale and complemented by a Needs Scale with several items. A grade above 3 on the visual analogue distress scale is a reliable indicator; a grade above 4 out of 20 leads us to propose the patient a consultation with a psychologist. Results: Two hundred and sixty-four female patients with a mean age of 61years are the object of the study. Among them, 59.2% of patients display a disarray of low intensity (psychological suffering graded between 0 and 2) whereas 40% show a grade equal or superior to 3, considered as pathological on a psychological side: 30% of the patients have a grade between 3 et 5 and less than 2% of the patients display a grade reaching 9 or 10. Concerning the Needs Scale, more than 80% of the patients show a total score below 10 out of 20 and we observe a positive correlation between the total score of the Needs Scale with several items and the Visual Analogue Distress Scale score. Conclusion: Our results highlight the difficulty for most of the patients to cope with emotional distress linked to their disease. We discuss the necessity to increase awareness among caregivers on this psychological distress, through the use of simple tools such as a Visual Analogue Scale associated with a Needs Scale, so as to provide a holistic care for women with breast cancer.
    No preview · Article · Sep 2015 · Bulletin du cancer
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    ABSTRACT: Introduction: Trabectedin proved its efficacy in relapsed advanced soft tissue sarcomas (STS) in 3 multicenter phase II studies with selected patients. The aim of the present study is to investigate trabectedin efficacy and tolerance in a cohort of "real-life" unselected patients with sarcoma. Methods: A single-center analysis was carried out on all consecutive patients with histologically proven unresectable advanced or metastatic STS, who received at least one cycle of trabectedin. Data on efficacy and tolerance were retrospectively reported. Results: From 2004 to 2014, data of 59 patients were reviewed. Median age was 62 years (from 23 to 87). A total of 317 cycles of trabectedin were administered. Twenty-five patients (42%) suffered grade 3-4 hematological toxicity, mainly with neutropenia (22 patients, 37%). Disease control rate was 24%, mainly with stable disease, and 45 patients (76%) experienced disease progression. Median overall survival was 6.6 months (95%CI [4.9-12.6]). Conclusion: Trabectedin might be an option for patients without any other validated alternative, but phase III study evaluating trabectedin+best supportive care (BSC) versus BSC is necessary.
    No preview · Article · Sep 2015 · Bulletin du cancer
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    ABSTRACT: Several studies have demonstrated that daily physical activity (PA) prevents the development of breast cancer. Our objective was to examine the relationship between PA and clinical and biological tumor characteristics in breast cancer patients in order to determine the impact of energy expenditure (EE) on tumor prognosis. We pooled data from two prospective studies, including a total of 121 breast cancer patients. The measure of PA was done using the self-completion Population Physical Activity Questionnaire, which was answered by each patient. Ten patients harbored triple negative (TN) tumors. The mean body mass index (BMI) in the general population and in patients with TN tumors was 24.3 and 25.6, respectively. The mean daily EE (DEE) was 10,266 kJ × 24 h(-1) in the general population and 11,212 kJ × 24 h(-1) in patients with TN tumors. In the whole population, there was an inverse statistical correlation between BMI and DEE, rest, low PA, and high PA (p = 0.0002, p = 0.003, p < 0001, and p = 0.03, respectively). There was a positive correlation between negative estrogen receptor status and intensive PA (p = 0.041) and DEE (p = 0.007). For TN tumors, there was no significant correlation between BMI and categories of EE. Lifestyle (weight regulation, PA) should be adapted and personalized according to biological, clinical, and epidemiological characteristics of the tumors. © 2015 S. Karger AG, Basel.
    No preview · Article · Aug 2015 · Oncology
  • Stéphane Vignot · Nicolas Magné

    No preview · Article · Aug 2015 · Bulletin du cancer
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    ABSTRACT: For patients with cervical cancer, intensity-modulated radiation therapy (IMRT) improves target coverage and allows dose escalation while reducing the radiation dose to organs at risk (OARs). In this study, we compared dosimetric parameters among 3-dimensional conformal radiotherapy (3D-CRT), "step-and-shoot" IMRT, and volumetric intensity-modulated arc radiotherapy (VMAT) in a series of patients with cervical cancer receiving definitive radiotherapy. Computed tomography (CT) scans of 10 patients with histologically proven cervical cancer treated with definitive radiation therapy (RT) from December 2008 to March 2010 at our department were selected for this study. The gross tumor volume (GTV) and clinical target volume (CTV) were delineated following the guidelines of the Gyn IMRT consortium that included cervix, uterus, parametrial tissues, and the pelvic nodes including presacral. The median age was 57 years (range: 30 to 85 years). All 10 patients had squamous cell carcinoma with Federation of Gynecology and Obstetrics (FIGO) stage IB-IIIB. All patients were treated by VMAT. OAR doses were significantly reduced for plans with intensity-modulated technique compared with 3D-CRT except for the dose to the vagina. Between the 2 intensity-modulated techniques, significant difference was observed for the mean dose to the small intestine, to the benefit of VMAT (p < 0.001). There was no improvement in terms of OARs sparing for VMAT although there was a tendency for a slightly decreased average dose to the rectum: - 0.65Gy but not significant (p = 0.07). The intensity modulation techniques have many advantages in terms of quality indexes, and particularly OAR sparing, compared with 3D-CRT. Following the ongoing technologic developments in modern radiotherapy, it is essential to evaluate the intensity-modulated techniques on prospective studies of a larger scale. Copyright © 2015 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
    No preview · Article · Jul 2015 · Medical dosimetry: official journal of the American Association of Medical Dosimetrists
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    ABSTRACT: Lung cancer is a major public health concern worldwide. Progress in improving 5-year survival is lagging behind comparable survival rates in other common cancers. The majority of patients with locally advanced non-small cell lung cancer (NSCLC) are not suitable for surgical resection, hence the major role of radical radiotherapy. Advances in radiotherapy techniques allow targeted treatment of the disease, whilst minimizing the dose to organs at risk. Recent research into fractionation schedules, with hyperfractionated and accelerated radiotherapy regimens has been promising. Platinum-based chemotherapy has long been the standard of care for the initial treatment of advanced NSCLC. However, if radical radiotherapy remains the cornerstone of treatment for patients with unresectable advanced NSCLC either as single modality treatment or with concomitant chemotherapy, advances in understanding of tumor molecular biology and targeted drug development should bring targeted agents into the NSCLC management. The development of numerous therapeutic approaches has made the locally advanced NSCLC world change. An up-to-date overview of the current literature on updated chemotherapeutic agents, targeted therapy, immunotherapy, radiotherapy in stage III NSCLC is provided. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    No preview · Article · Jun 2015 · Critical reviews in oncology/hematology

Publication Stats

2k Citations
569.17 Total Impact Points


  • 2012-2016
    • Institut de cancérologie Lucien-Neuwirth
      La Fouillouse, Rhône-Alpes, France
  • 2015
    • Université Jean Monnet
      Saint-Étienne, Rhône-Alpes, France
  • 2014
    • Claude Bernard University Lyon 1
      Villeurbanne, Rhône-Alpes, France
  • 2012-2013
    • University of Lyon
      Lyons, Rhône-Alpes, France
  • 2007-2012
    • Institut de Cancérologie Gustave Roussy
      • Department of Radiotherapy
      Villejuif, Île-de-France, France
  • 2009-2010
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      Lutetia Parisorum, Île-de-France, France
  • 2004-2009
    • Institut Jules Bordet
      • Department of Nuclear Medicine
      Bruxelles, Brussels Capital, Belgium
  • 2006
    • Université Libre de Bruxelles
      • Bordet Institute
      Bruxelles, Brussels Capital Region, Belgium
  • 2000-2006
    • Centre Antoine-Lacassagne
      Nice, Provence-Alpes-Côte d'Azur, France